Aortic dissection is a relatively rare but dreadful illness, often presenting with tearing chest pain and acute hemodynamic compromise. We report a case of a patient with suspected food poisoning that turned out to be aortic dissection. With high level of suspicion, the patient was diagnosed at the earliest but soon developed cardiac tamponade for which pericardiocentesis was done, but the patient developed cardiac arrest and died within few hours of presentation to the hospital. We discuss the controversial role of pericadiocentesis in cardiac tamponade complicating aortic dissection.